Q: I am 24 years old suffering from neurofibromas all over the body -- hands, abdomen, chest and thighs. Is this a neurological disorder or a hereditary problem, as my father and grandfather too had the same problem, but not as severe as mine. What is the cure other than surgery?

A:Neurofibroma is both a neurological and genetic problem. The description given below may be useful to you. Neurofibroma is one of the two most common types of benign tumours that arise from nerves. The other is schwannoma. Neurofibromas, which mostly affect young adults, most often arise as a solitary tumour, but sometimes arise as multiple tumours. Neurofibromas usually affect nerves that are close to the surface of the body such as nerves of the skin or tissue just beneath the skin. However, these can occur in any nerve. Unlike schwannomas, which are easily separated from the host nerve with surgery, neurofibromas are intimately involved with the nerve structure. The cause of neurofibroma is unknown. It sometimes occurs in patients with von Recklinghausen disease (neurofibromatosis). The following are the most common symptoms of neurofibroma. Patients may experience symptoms differently depending on the location and size of the tumour or tumours. Symptoms include: painless, slow growing mass, sometimes pain, electric like shock when affected area is felt (known as Tinel sign), usually no neurological problems or neural loss unless the tumour involves a major motor or sensory nerve or is compressed between the tumour and a rigid structure. The symptoms of a neurofibroma may resemble those of other medical conditions. Always consult a doctor for the diagnosis. In addition to undergoing a complete physical examination and medical history, one or more of the following tests may be done:

• X ray - a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto a film. Neurofibromas are not seen well on x rays, but an x ray should be obtained to ensure that the adjacent bone is not involved.
• Ultrasound - an imaging technology that uses high frequency sound waves to view internal organs and structures and produce diagnostic pictures of the human body. Ultrasound is sometimes useful to detect soft tissue masses.
• Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radio frequencies and a computer to produce detailed images of organs and structures within the body.
• Biopsy of the tumour - A simple surgical procedure during which a tissue sample from the tumour is taken and then viewed under a microscope.

The exact treatment for neurofibroma may vary from person to person, depending on the patient's age, overall health and medical history. It has to be seen which nerves are affected and whether the condition is causing symptoms, patient's tolerance to specific procedures or therapies, how the treating doctor expects the disease to progress and your opinion or preference. If the neurofibroma is not involved with a major nerve, an operation to remove the nerve containing the tumour is usually the treatment of choice. If a major nerve is involved, doctors may choose to excise the tumour from the nerve, leaving the nerve itself intact, or leave the tumour alone, if it isn't causing any symptoms.